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Lung Collapse

Lung Collapse occasionally takes place, most frequently after surgical operations, due to obstruction occurring in a bronchus. The air in the portion of lung on the far side of this is absorbed, and the lung simply collapses. It tends to occur chiefly in the right lower lobe, and it may come on one to four days after surgery.

Lung Collapse Symptoms

If the collapse is major, there is pain in the lower part of the chest behind the sternum (breastbone), accompanied by severe breathlessness, restlessness and a bluish tinge to the face. An increased rate of breathing, increased heart rate and fever may follow. This may be followed by considerable infection in the affected part. Unless relief is forthcoming soon, it is possible for permanent bronchiectasis to develop in the affected portion of lung.

Lung Collapse Treatment

In patients intending to undergo surgery, lung collapse can often be prevented by sensible measures taken beforehand. These include cessation of smoking, the doctor not operating on any patient with a chest infection, for there is a much higher risk of a mucus plug becoming lodged in an air passageway during or after the anesthetic. The patient should be encouraged to move about and cough as soon as possible after the operation, to dislodge any impending obstruction, such as mucus in the airways.

If collapse does occur, physiotherapy by a skilled practitioner may assist. Otherwise, investigation with the bronchoscope is essential. Antibiotics are needed if there is any delay in initiating therapy.

Emotional Symptoms During Second Trimester Pregnancy

Most women find the second trimester to be a more positive experience that the first, as they are now beginning to feel the movements of the life with them. Most husbands by now have accepted the existence of the pregnancy, and are as excited as the woman about the movements of the baby. During the second trimester, men frequently also become more aware of their wife’s growing dependence on them. As the pregnancy progresses, the woman may feel more vulnerable and may need her mate’s attention more. She may want him to become more involved with the pregnancy and the baby. In addition, she may become overly concerned for her husband’s safety. Meanwhile, the husband may share the woman’s interest in the pregnancy, or he may feel an increased creative interest in his work or hobby. He may gain weight or show other symptoms of pregnancy. These are all ways in which expectant mothers and fathers deal with the stresses and changes that are occurring. It is important for both partners to be aware of and to talk about their feelings, especially when friction arises between them.

A woman’s dreams may become very real during this trimester and are sometimes disturbing. Dreams are a way of bringing fears to consciousness, where they can be dealt with more easily. If a woman refuses to acknowledge her fears, she may suffer increasing anxiety.

Loss of Consciousness

Unconsciousness occurs when the oxygen supply to the brain becomes inadequate. There is not enough oxygen for the nervous system to control normal activities. So there may be a slow or gradual dulling of senses, often precipitated by a slowing of movements, general vagueness and finally dizziness, maybe drowsiness and finally a total lack of consciousness. Often this may be simple, due to fainting, where a momentary lack of oxygen occurs, and recovery is usually quick. However, there may be other serious underlying causes present as well. The patient may be a diabetic suffering from excessively high sugar levels (diabetic coma) that require urgent treatment to prevent death. Or there may be too much insulin as a result of treatment undertaken when the patient may have missed meals or over exercised, or some other condition.

Epilepsy is a well-known cause of unconsciousness, and the patient may have a series of convulsions prior to lapsing into the unconscious state. The situation may have occurred as a result of accident, in which case there is usually some other indication at the same time. It may have been due to trauma to the brain.

Many drugs and poisons may produce unconsciousness, and this includes alcoholic excesses. There may be evidence of these about the patient. A heart attack may have occurred, or the patient may have been electrocuted, in which case there is usually some obvious evidence.

When first confronted with an unconscious patient, they will have little knowledge of what has taken place. Therefore, a quick, preliminary assessment is essential.

After this, attention to general principles of treatment is urgently needed. The brain is unable to withstand oxygen deprivation from vital cells very long, and unless this is restored within a few minutes, irreversible brain damage is likely. If the heart has stopped beating, and breathing is diminishing or has also ceased, immediate steps at resuscitation are vital. Unless these two centers commence operating again, so allowing the blood flow to recommence and the blood to become reoxygenated, then the patient’s life is in grave peril.

Every first aider must have an intimate knowledge of the simple, effective methods of resuscitation and know how to commence these in a few moments. The first alder must know when they are needed, then how to carry them out. As these are fairly tiring, it is always advisable to have an assistant also conversant with the methods available to take over, so allowing periods of rest.

Loss of Consciousness Causes

It is always worth checking in the patient’s pockets, briefcase or handbag to see if there are any clues relating to possible disabilities. Sometimes patients with known chronic diseases (particularly diabetics, epileptics, heart cases) carry notification cards:

  • Stating their disease, with phone numbers and instructions regarding emergency care or medical warning medallions or bracelets. These may be vital, so always check.
  • Some cars have stickers with similar information, and glove boxes of cars may carry records.

Sometimes bystanders may be able to offer some indication of what occurred prior to the attack, and this may assist, such as in epileptics who may throw convulsions before lapsing into unconsciousness. See the sections on head injuries, stroke, fainting, epileptic fits, drunkenness, diabetic coma and hypoglycemic coma for some of the probable causes of unconsciousness. The treatment will be basically the same in each case but in some instances further treatment may be available

There are many causes of unconsciousness, but the immediate emergency treatment is the same. As soon as this has been carried out, the basic cause may be found, and sonic further treatment offered.

In any case, the sooner the patient is taken to expert medical attention (such as the emergency centre of a large hospital) the better. Many causes of unconsciousness are serious, necessitating urgent treatment.

Loss of Consciousness Symptoms

  1. The patient’s unconscious, and does not respond to normal stimulation, such as when spoken to or touched.
  2. There may be obvious causes present, such as hemorrhaging, vomiting, fluid loss from burns, diarrhea, or the obvious result from an accident.
  3. There may be eyewitness accounts of fits preceding the loss of consciousness. The patient may be a known diabetic, epileptic or heart patient. He or she may be an alcoholic.
  4. There may be evidence of what has caused the problem: sleeping-pill bottles, other medication containers, poison, drugs, bottles of alcohol, knives, guns etc.

What to Do in the Case of Unconsciousness

  1. Act promptly but remain calm and efficient. If you are scared and feel incompetent, call for immediate assistance. In any case, summon an ambulance for transport to hospital.
  2. Remove patient from the cause if further danger is imminent (e.g. electrical accidents).
  3. Turn patient on side. Make certain air passages are not blocked. If they are, remove any debris as a matter of urgency. Check for breathing and commence expired air resuscitation if necessary.
  4. Feel for pulse at neck if not present, immediate external cardiac compression is essential.
  5. If breathing and pulse are present, place the patient in the stable side position. This excellent position allows unwanted secretions (such as blood, vomitus, mucus or food) to drain from the body and reduces the risk of breathing obstruction.
  6. Check for bleeding and other injuries. Manage these.
  7. Under no circumstance give anything by mouth. This applies to fluid or alcoholic beverages. Oral administration could choke.
  8. Watch the patient’s color. A bluish color means inadequate oxygenation. A normal pink color means the patient is getting adequate amounts, and is in a far better position.
  9. Never leave the patient unless under adequate supervision of somebody with first aid or professional skill.
  10. Get medical aid as promptly as possible. Often, in serious cases, the emergency ward of a hospital is imperative. At this stage you do not know the cause, so plan for transportation promptly.
  11. Check in pockets, handbags or glove boxes for any identification of disease, as many chronics carry identification cards (or some other medical-warning device) setting out their disease, plus measures to be used in an emergency. These are often valuable.

Spinal Cord Facts

  • The spinal cord is the bundle of nerves running down the middle of the backbone.
  • The spinal cord is the route for all nerve signals traveling between the brain and the body.
  • The spinal cord can actually work independently of the brain, sending out responses to the muscles directly.
  • The outside of the spinal cord is made of the long tails or axons of nerve cells and is called white matter; the inside is made of the main nerve bodies and is called grey matter.
  • Your spinal cord is about 43 cm long and I cm thick. It stops growing when you are about five years old.
  • Damage to the spinal cord can cause paralysis.
  • Injuries below the neck can cause paraplegia — paralysis below the waist.
  • Injuries to the neck can cause quadriplegia — paralysis below the neck.
  • Descending pathways are groups of nerves that carry nerve signals down the spinal cord – typically signals from the brain for muscles to move.
  • Ascending pathways are groups of nerves that carry nerve signals up the spinal cord – typically signals from the skin and internal body sensors going to the brain.

Symbiosis Facts

  • Living things that feed off other living things are called parasites.
  • Living things that depend on each other to live are called symbiotic.
  • Many tropical rainforest trees have a symbiotic relationship with fungi on their roots. The fungi get energy from the trees and in return give the trees phosphorus and other nutrients.
  • A phyte is a plant that grows on another plant.
  • Epiphytes are plants that grow high up on other plants, especially in tropical rainforests.
  • Many plants rely on bees and butterflies to spread their pollen. In return, they give nectar.
  • Saprophytes are plants and fungi that depend on decomposing material, not sunlight, for sustenance.
  • Most orchids are saprophytic as seedlings.
  • Corsiaceae orchids of New Guinea, Australia and Chile are saprophytic all their lives.
  • Various ants, such as leaf-cutter and harvester ants in tropical forests, line their nests with leaves which they cut up. The leaves provide food for fungi which, in lure, provide food for the ants.

Chemical Compound Facts

  • Compounds are substances that are made when the atoms of two or more different elements join together.
  • The properties of a compound are usually very different from those of the elements which it is made of.
  • Compounds are different from mixtures because the elements are joined together chemically. They can only be separated by a chemical reaction.
  • Every molecule of a compound is exactly the same combination of atoms.
  • The scientific name of a compound is usually a combination of the elements involved, although it might have a different common name.
  • Table salt is the chemical compound sodium chloride. Each molecule has one sodium and one chlorine atom.
  • The chemical formula of a compound summarizes which atoms a molecule is made of. The chemical formula for water is H 20 because each water molecule has two hydrogen (H) atoms and one oxygen (0) atom.
  • Table salt, or sodium chloride, forms when sodium Hydroxide neutralizes hydrocloric acid.
  • There only 100 or so elements but they can combine in different ways to form many millions of compounds.
  • The same combination of elements, such as carbon and hydrogen, can form many different compounds.
  • Compounds are either organic (see organic chemistry), which means they contain carbon atoms, or inorganic.

Fox Facts

  • The larder of one Arctic fox was found to contain 50 lemmings and 40 little auks, all lined up with tails pointing the same way and their heads bitten off.
  • African bat-eared foxes have huge ears for radiating heat away from the body.
  • Arctic foxes live only 480 km from the North Pole.
  • The grey fox of North and Central America is the oldest surviving member of the dog family, first appearing 9 million years ago.
  • The African fennec fox’s 15-cm long ears are the largest of any carnivore.
  • The American grey fox leaps with ease between tree branches.
  • Some foxes roll about and chase their tails to ‘charm’ rabbits, which seem fascinated and come closer, allowing the fox to make a grab.
  • The red fox has adapted with great success to urban life, even moving into houses via cat flaps.
  • When locating insects beneath the ground, the bat-eared fox cups its large ears, gradually pinpointing the exact position of the prey before digging.
  • In early autumn, up to 90% of the red fox’s diet may consist of apples, blackberries and other fruits.
  • Basically a night hunter, the red fox is often seen during the day, and shows up sharply against winter snow.

Leukemia

What is Leukemia?

Leukemia means malignant disease, or cancer, of the blood-cell-producing areas in the bone marrow. When we think about cancer, it usually involves one of the organs of the body. Instead of the abnormal cells concentrated in one area, they are scattered irregularly throughout the bloodstream. But rather than the cells of the blood being the prime source, they are the aftermath. The disease commences in the manufacturing centres of the white cells. The main place is the bone marrow. There are various kinds, but most are the so-called “acute forms” in childhood, and the age between two and five years is the most probable.

There is an enormous increase in the number of white cells produced, and because of this overproduction, very young, immature cells termed blast cells are present in large numbers, and these are poured out into the general circulation. Although the cause of cancer in general is still an enigma, at least son-le of the causes of leukaemia has become well-established. It is well-known that in many animals leukaemia is transmitted by a virus, although this has not yet been proved conclusively in humans.

In humans, however, there is a distinct relationship with irradiation. Evidence has now been available for some years of the massive increase in leukaemia in victims following the atomic bomb explosions in Japan.

Patients who were treated for severe back pain (due to ankylosing spondylitis) with radiotherapy have since shown a greatly increased incidence of leukaemia in later life.

It is also well-known that pregnant women who undergo X-ray examinations give birth to children who run a higher-than-average risk of later developing leukaemia. Even prenatally the X-rays are able to disrupt the sensitive cellular mechanism later to produce severe disease. For this reason doctors are strong in advising pregnant women to defer, if possible, any form of X-ray during pregnancy.

It is known that leukaemia is more common in children with Down’s syndrome (mongolism). It is also significant that the chromosomal anomaly occurs on the same chromosome as does the Down’s syndrome aberration.

Exposure to certain chemicals, particularly benzene, may also be a cause. It seems that the disease is increasing in frequency. Figures for Great Britain showed that 722 died from it in 1949, 939 in 1957, and 1495 in 1967. No doubt improved methods of diagnosis accounted for some, but certainly not all of these increases.

There are various forms of acute leukaemia. Some affect chiefly children, others afflict adults more commonly. There seems to be a preponderance of males to females, the ratio being about three to two.

Leukemia Symptoms

From a practical point of view the most probable combination of symptoms from the start are anaemia haemorrhage and infections. Often it starts off with symptoms similar to a child with ordinary red cell anaemia. In fact, there is often anaemia present. There may be a mild fever, weakness, pains in the bones and perhaps pains in the joints. There may be abnormal bleeding, such as from the gums, 108 nose or into the bladder. This may be the first indication that all is not right. The child may have a tendency to bruise easily. Sometimes there is an enlargement of the lymph glands in various parts of the body, or the liver or spleen (in the upper part of the abdominal cavity) may enlarge, but this is not always the case. They all vary. It seems that children with Down’s syndrome are more likely to develop the disorder. How does the doctor diagnose it? The doctor can call on many special tests. Initially the blood count will be checked, and this may show too many white cells – sometimes there are abnormally low numbers. But their shape and type is highly abnormal. It indicates that many are being formed. Often there is red cell anaemia also, and the platelets, the clotting factor, may be deficient.

In more detail, the symptoms will be a collection of these. Often when first seen the patient will be pale, quite ill and be running an elevated temperature from an underlying infection that may or may not be obvious. It may be a simple sore throat, a bout of bronchitis, tonsillitis, pleurisy or pneumonia or something else. There may be obvious bruising of the skin or mucous membranes, or frank bleeding from the gums or lower part of the intestinal system. The spleen may be enlarged, and it may be possible to feel it jutting from below the rib margin on the upper left-hand side of the abdomen. In some cases there may be enlargement of the lymph glands in the neck, under the arms and in the groin.

Blood tests and tests of bone marrow show the telltale story. There is the presence of typical leukaemic cells in profusion. As the disease advances it may infiltrate many other organs of the body. The central nervous system seems particularly vulnerable, and involvement may occur early, producing signs of meningitis and infiltration of the nerves of the head or extremities. The skin, testes, pelvic organs, kidneys, liver and intestine may also be attacked, and symptoms may occur as a result of this.

The triad of anaemia, haemorrhage and infection immediately arouses suspicion of leukaemia, and indicates that blood tests should be carried out to establish the diagnosis.

The normal white-cell count of the blood, usually between 4.0 and 11.0 thousand million cells per litre (written as 4.0 – 10.0 x 109/L), can rise dramatically to figures of 50.0 or more. Many primitive blast cells may be in evidence. However, in certain so-called leukemic forms, there may be a dramatic reduction in the white cell count to 1.0 or less. The precise type of leukemia usually depends on the nature of the white cells in greatest evidence (and so the profusion of names in this disease).

Leukemia Treatment

With the development of specialised units in many large hospitals, usually located in key capital cities, intensive therapy is now available. This usually encompasses powerful, relatively new drugs, and parents will soon become familiar with names such as prednisone, vincristine, mercaptopurine, methotrexate, cyclophosphamide and various others. Also, in more recent years, marrow transplants have become popular and dramatically successful. Cells taken from the bone marrow of a suitable person (ideally a twin of the patient) can often take hold and produce normal white cells. National bone marrow registers are being set up in Australia to quickly match suitable donors with patients. This will again enhance the chances of successful treatment. Collectively, this has made the outlook for the leukaemia patient much better than at any previous time in history. Now many centres claim “cures” for their youthful patients. Of course, only the future will prove if this will last a lifetime, but the current evidence seems to indicate that, in many cases, it probably will. What is the important message here? Parents must be alert to the possible symptoms of leukaemia, and report any untoward symptoms – the kind we have talked about – to the doctor immediately. Even simple recurring nosebleeds or bleeding gums warrant investigation. This can easily be arranged. If by some misfortune leukaemia is present, the sooner this is treated, the better. Becoming associated with a major centre is the ideal. Acute cases are not treated at home, and there is no place for do-it-yourself remedies. Specialised instruction and care is mandatory. Unfortunately, there are still a few misguided parents around who think that natural remedies and good food may cure their child. This is not so. Please be cautioned. We certainly condone do-it-yourself remedies whenever practical, but this disease is not one of them.

Acute lymphoblastic leukaemia responds dramatically to treatment, and instead of being a death sentence, a cure seems possible. To quote from one eminent authority: “One of the most remarkable events in malignant disease is that a complete remission is now possible in about 95 per cent of children with lymphoblastic leukaemia.” A “complete remission” means “a complete return to normal of the blood and bone marrow, no abnormal signs such as an enlarged spleen, and no evidence of the disease elsewhere.” To achieve this situation with a malignant disease certainly gives reason for optimism. This has occurred only in the past few years, and is a result of the research and aggressive approach that has recently been made in therapy.

Gaining complete remission is the start. After this, vigorous follow-up treatment is needed to retain this situation and prevent recurrences.

Various forms of drug therapy are now in wide use. These will vary in form from centre to centre, and from patient to patient. In fact, the pattern is changing rapidly.

Generally speaking, therapy entails the use of the so-called cytotoxic drugs, including vincristine and prednisone. Also in use are cytosine arabinoside, daunorubicin, asparaginase and BCNU. When remissions have taken place, other drugs are introduced to maintain the good work. Drug names such as 6-mercaptopurine, methotrexate and cyclophosphamide are well-established.

When the remission has settled down, maintenance treatment with combinations of these drugs is kept up. Marrow transplants also form an important and often successful form of treatment.

The treatment of leukaemia is in a specialised unit in a major hospital where doctors who expert in this particular specialty are in charge.

Therapy is intensive, and there is often accompanying toxicity due to medication, which is quite separate from the symptoms invoked by the disease itself. “However, the aggressive approach to the treatment of acute leukaemia is justified by the results,” one investigator says, and gives the results of Burchenal who collected the results of 157 cases of proven leukaemia of all types from around the world who were still alive after five years, and of whom 103 are free from disease five to 17 years later. Subsequent journal reports are giving progressively more satisfactory results each year.

Once, the outlook for children with acute leukaemia was less than five months. Now, with intensive combination therapy, it is more than three years, and in many cases it seems curable. Today’s aim is to cure the disease totally although this may rarely be the case, the outlook is increasingly promising.

Leukemia requires prompt attention from the doctor. The sooner a definitive diagnosis is made, the quicker modern treatment can be started and the greater is the chance of a cure or at least a greatly enhanced life span compared to yesteryear.

Bat Facts

  • Bats are the only flying mammals. Their wings are made of leathery skin.
  • Most types of bat sleep during the day, hanging upside down in caves, attics acid other dark places. They come out at night to hunt.
  • Bats find things in the dark by giving out a series of high-pitched clicks — the bats tell where they are and locate (find) prey from the echoes (sounds that bounce back to them). This is called echo location.
  • Bats are not blind — their eyesight is as good as that of most humans.
  • There are 900 species of bat, living on all continents except Antarctica.
  • Most bats feed on insects, but fruit bats reed on fruit.
  • Many tropical flowers rely on fruit bats to spread their pollen.
  • Frog-eating bats can tell edible frogs from poisonous ones by the frogs’ 0iating calls.
  • The vampire bats of tropical Latin America feed on blood, sucking it from animals such as cattle and horses. A colony of 100 vampire bats can feed from the blood of 25 cows or 14,000 chickens in one night.
  • False vampire bats are bats that do not suck on blood, but feed on other smalI creatures such as bats and rats. The greater false vampire bat of Southeast Asia is one of the biggest of all bats.
  • There are about 130 species of fruit bat known as flying foxes. They fly on leathery wings, which can span as much as 1.8 m, to feed on fruits such as bananas and figs.

Black Bear Facts

  • American black bears vary in colour from black, through brown, cinnamon, honey and ice-grey, to white, according to regional races.
  • Beavers are a favourite food of some black bears, because of their high fat content.
  • In autumn, when they are feeding up for the winter sleep, black bears put on up to 1.5 kg per day.
  • Black bears mate in the summer, but the fertilized egg does not begin to develop until the autumn, and the cubs are born in January or February.
  • Black bears occasionally raid people’s beehives and orchards, as well as city dumps.
  • Black bears are excellent climbers and in autumn will climb trees and gorge themselves on fruit, nuts and berries.
  • ‘Nuisance’ bears that have learned to beg and scavenge garbage in US national parks have to be tranquillized and moved to new areas some distance away.
  • The most northerly Canadian black bears have a varied diet ranging from caribou and seals to birds’ eggs and tiny shrimp.
  • The sun bear of Southeast Asia is the world’s smallest bear, at 27-65 kg. It specializes in gathering honey and insects with its long tongue.
  • South America’s only bear is the spectacled bear, which builds feeding and sleeping platforms in the branches of fruit trees.
  • The black sloth bear of India has a mobile snout and closable nostrils for dealing with ants.
  • Asiatic black bears are constipated when they awake from their winter hibernation, and in Russia they drink birch tree sap as a laxative.